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Emergence of Mycobacterium Tuberculosis with Extensive Resistance to Second-Line Drugs – Worldwide, 1993-2004
Findings published today by CDC contain the first global data on highly drug-resistant TB.
In a survey of a global network of supranational TB reference laboratories located on six continents, extensively drug-resistant (XDR) TB, or multi-drug resistant (MDR) TB that is also resistant to three of the six classes of second-line drugs, was identified in 2 percent of the isolates. XDR TB was identified in all regions of the world, including the Unites States. XDR TB cases increased slightly, but not significantly, in the United States from 3.9 percent of MDR TB cases in the early nineties to 4.5 percent by the end of 2004. Population-based data were also reported for Latvia and South Korea, where XDR TB now accounts for 15 percent or greater of MDR TB cases. Worsening drug resistance worldwide poses a serious threat to our ability to treat and control TB, as treating patients with drug-resistant TB is costly, drugs are toxic and expensive, and patients with XDR TB are virtually untreatable according to international guidelines in most countries. It is critical to take steps now to prevent the further spread of highly-resistant TB. CDC is working with partners to raise awareness and enhance strategies for TB control worldwide.
A CDC analysis of national tuberculosis (TB) surveillance data shows slowing progress in the United States’ efforts to eliminate TB.
In 2005, the rate of TB in the United States fell to an all-time low of 4.8 cases per 100,000 people, or a total of 14,093 active cases. The decline (3.8 percent), however, was one of the smallest in more than a decade. Despite this decline, multi-drug resistant (MDR) TB cases in the Unites States increased 13.3 percent from 2003-2004, the largest one year increase since the early 1990s. While MDR TB cases still only account for 1.2 percent of cases for which this data are available, these cases are more costly and difficult to treat and can be fatal. TB continues to disproportionately impact many communities in the United States. Foreign-born individuals accounted for more than half of all new TB cases and had a case rate almost 9 times higher than U.S.-born individuals (21.8 vs. 2.5 cases per 100,000). Compared with whites, Asians, blacks, and Hispanics were 20, 8, and 7 times more likely to have TB, respectively. The authors note that multiple steps will be needed to accelerate progress and guard against TB resurgence.
While these findings illustrate a small and encouraging increase in the use of colorectal cancer tests, a large burden of preventable colorectal cancer remains, and measures to increase awareness and encourage regular colorectal cancer screening must be continued to reduce mortality from colorectal cancer.
Colorectal cancer is the second leading cause of cancer-related
death in the United States. The findings in this report indicate that the
number of states/areas where greater than 60 percent of the population
have been screened as recommended for colorectal cancer nearly doubled
from eight in 2002 to 15 in 2004. Although this increase in reported use
of colorectal cancer tests is encouraging, a large burden of preventable
colorectal cancer remains, and measures to increase awareness and encourage
regular colorectal cancer screening must be continued to reduce mortality
from this disease. To increase colorectal cancer screening, in August 2005
CDC awarded five cooperative agreements to establish colorectal cancer
screening demonstration programs for low-income U.S. men and women aged
greater than 50 years who have inadequate or no colorectal cancer screening
insurance coverage at these sites: The Research Foundation of SUNY at Stony
Brook, New York (county-based: Suffolk County); Nebraska Department of
Health and Human Services (statewide); Missouri Department of Health and
Senior Services (city-based: St. Louis), Maryland Department of Health
and Mental Hygiene(city-based: Baltimore); Seattle and King County, Washington
(county-based: King, Clallam, and Jefferson counties).
This page last reviewed March 23, 2006
Disease Control and Prevention